Topical cutaneous application of CO2 accelerates bone healing in a rat femoral defect model View Full Text


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Article Info

DATE

2019-05-22

AUTHORS

Yu Kuroiwa, Tomoaki Fukui, Shunsuke Takahara, Sang Yang Lee, Keisuke Oe, Michio Arakura, Yohei Kumabe, Takahiro Oda, Tomoyuki Matsumoto, Takehiko Matsushita, Toshihiro Akisue, Yoshitada Sakai, Ryosuke Kuroda, Takahiro Niikura

ABSTRACT

BACKGROUND: Bone defects may occur because of severe trauma, nonunion, infection, or tumor resection. However, treatments for bone defects are often difficult and have not been fully established yet. We previously designed an efficient system of topical cutaneous application of carbon dioxide (CO2) using a novel hydrogel, which facilitates CO2 absorption through the skin into the deep area within a limb. In this study, the effect of topical cutaneous application of CO2 on bone healing was investigated using a rat femoral defect model. METHODS: In this basic research study, an in vivo bone defect model, fixed with an external fixator, was created using a rat femur. The affected limb was shaved, and CO2 was applied for 20 min/day, 5 days/week. In the control animals, CO2 gas was replaced with air. Radiographic, histological, biomechanical, and genetic assessments were performed to evaluate bone healing. RESULTS: Radiographically, bone healing rate was significantly higher in the CO2 group than in the control group at 4 weeks (18.2% vs. 72.7%). The degree of bone healing scored using the histopathological Allen grading system was significantly higher in the CO2 group than in the control group at 2 weeks (1.389 ± 0.334 vs. 1.944 ± 0.375). The ultimate stress, extrinsic stiffness, and failure energy were significantly greater in the CO2 group than in the control group at 4 weeks (3.2 ± 0.8% vs. 38.1 ± 4.8%, 0.6 ± 0.3% vs. 41.5 ± 12.2%, 2.6 ± 0.8% vs. 24.7 ± 5.9%, respectively.). The volumetric bone mineral density of the callus in micro-computed tomography analysis was significantly higher in the CO2 group than in the control group at 4 weeks (180.9 ± 43.0 mg/cm3 vs. 247.9 ± 49.9 mg/cm3). Gene expression of vascular endothelial growth factor in the CO2 group was significantly greater than that in the control group at 3 weeks (0.617 ± 0.240 vs. 2.213 ± 0.387). CONCLUSIONS: Topical cutaneous application of CO2 accelerated bone healing in a rat femoral defect model. CO2 application can be a novel and useful therapy for accelerating bone healing in bone defects; further research on its efficacy in humans is warranted. More... »

PAGES

237

References to SciGraph publications

  • 2007-06-15. Immersion in CO2-rich water containing NaCl diminishes blood pressure fluctuation in anesthetized rats in INTERNATIONAL JOURNAL OF BIOMETEOROLOGY
  • 2010-10-22. Carbon dioxide balneotherapy and cardiovascular disease in INTERNATIONAL JOURNAL OF BIOMETEOROLOGY
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1186/s12891-019-2601-5

    DOI

    http://dx.doi.org/10.1186/s12891-019-2601-5

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1115023249

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/31113412


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    20 schema:description BACKGROUND: Bone defects may occur because of severe trauma, nonunion, infection, or tumor resection. However, treatments for bone defects are often difficult and have not been fully established yet. We previously designed an efficient system of topical cutaneous application of carbon dioxide (CO<sub>2</sub>) using a novel hydrogel, which facilitates CO<sub>2</sub> absorption through the skin into the deep area within a limb. In this study, the effect of topical cutaneous application of CO<sub>2</sub> on bone healing was investigated using a rat femoral defect model. METHODS: In this basic research study, an in vivo bone defect model, fixed with an external fixator, was created using a rat femur. The affected limb was shaved, and CO<sub>2</sub> was applied for 20 min/day, 5 days/week. In the control animals, CO<sub>2</sub> gas was replaced with air. Radiographic, histological, biomechanical, and genetic assessments were performed to evaluate bone healing. RESULTS: Radiographically, bone healing rate was significantly higher in the CO<sub>2</sub> group than in the control group at 4 weeks (18.2% vs. 72.7%). The degree of bone healing scored using the histopathological Allen grading system was significantly higher in the CO<sub>2</sub> group than in the control group at 2 weeks (1.389 ± 0.334 vs. 1.944 ± 0.375). The ultimate stress, extrinsic stiffness, and failure energy were significantly greater in the CO<sub>2</sub> group than in the control group at 4 weeks (3.2 ± 0.8% vs. 38.1 ± 4.8%, 0.6 ± 0.3% vs. 41.5 ± 12.2%, 2.6 ± 0.8% vs. 24.7 ± 5.9%, respectively.). The volumetric bone mineral density of the callus in micro-computed tomography analysis was significantly higher in the CO<sub>2</sub> group than in the control group at 4 weeks (180.9 ± 43.0 mg/cm<sup>3</sup> vs. 247.9 ± 49.9 mg/cm<sup>3</sup>). Gene expression of vascular endothelial growth factor in the CO<sub>2</sub> group was significantly greater than that in the control group at 3 weeks (0.617 ± 0.240 vs. 2.213 ± 0.387). CONCLUSIONS: Topical cutaneous application of CO<sub>2</sub> accelerated bone healing in a rat femoral defect model. CO<sub>2</sub> application can be a novel and useful therapy for accelerating bone healing in bone defects; further research on its efficacy in humans is warranted.
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    49 days
    50 days/week
    51 deeper areas
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    54 degree
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    65 factors
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    68 femur
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    74 grading system
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    81 hydrogels
    82 infection
    83 limb
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    85 min/day
    86 mineral density
    87 model
    88 nonunion
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    95 resection
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    97 skin
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